Individual provider Active NPI

Stephen Miller Driscoll, PA-C

  • Physician Assistant
  • Willow Grove, PA
National Provider Identifier
1720716327
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA066803 Issued in PA
Practice address
2400 Maryland Rd Ste 20
Willow Grove, PA 19090-1732
Phone
(800) 321-9999
Fax
(609) 267-2533
NPI assigned
Aug 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00724400 NJ
Physician Assistant 363A00000X MA066803 PA Primary

Addresses

Primary practice location

2400 Maryland Rd Ste 20
Willow Grove, PA 19090-1732

Mailing address

2247 Montrose St
Philadelphia, PA 19146-2529
Phone (215) 983-2809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220830003237 NJ Practitioner - Physician Assistant 2668856303 Reassigns benefits to 2 organizations
I20250721002467 PA Practitioner - Physician Assistant 2668856303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Cranberry Township, PA 16066-5238

2400 Maryland Rd
Willow Grove, PA 19090-1700
Phone (215) 830-8700

925 Chestnut St
FL 5
Philadelphia, PA 19107-4206
Phone (267) 339-3500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00724400NJMDPhysician Assistant
MA066803PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rothman Orthopaedics of New Jersey, LLC Orthopaedic Surgery CurrentSince Aug 18, 2025 Accepting new patients
Rothman Institute of New Jersey, P.a. CurrentSince Aug 18, 2025 Accepting new patients
Reconstructive Orthopaedic Associates II LLC Orthopaedic Surgery CurrentSince Aug 18, 2025 Accepting new patients
Reconstructive Orthopaedic Associates II LLC Orthopaedic Surgery CurrentSince Aug 18, 2025 Accepting new patients

Locations

999 Route 73 N
Ste 401
Marlton, NJ 08053

833 Chestnut St
Ste 520
Philadelphia, PA 19107
Phone (267) 592-6191

925 Chestnut St
Fl 5
Philadelphia, PA 19107
Phone (267) 339-3738

2400 Maryland Rd
Ste 20
Willow Grove, PA 19090
Phone (215) 830-8700

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1720716327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2247 MONTROSE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191462529",
            "telephone_number": "215-983-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MARYLAND RD STE 20",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901732",
            "telephone_number": "800-321-9999",
            "fax_number": "609-267-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRISCOLL",
        "first_name": "STEPHEN",
        "middle_name": "MILLER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-11",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00724400",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA066803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Grove, PA

Sources for this page

Verify at the official NPI Registry.